经肛闭式修补术联合自拟助阳通便膏方口服治疗重度直肠前突的临床研究  

Transanal repair combined with oral Zhuyang Tongbian paste in treating severe rectocele

作　　者：胡占起[1] 隋楠[1] Hu Zhanqi;Sui Nan(Department of Anorectal Surgery,The Third Affiliated Hospital of Liaoning University Traditional Chinese Medicine,Shenyang 110003,Liaoning,China)

机构地区：[1]辽宁中医药大学附属第三医院肛肠科,辽宁沈阳110003

出　　处：《结直肠肛门外科》2020年第2期213-216,共4页Journal of Colorectal & Anal Surgery

基　　金：国家自然科学基金青年科学基金项目(81503576)。

摘　　要：目的探讨经肛闭式修补术联合自拟助阳通便膏方口服治疗重度直肠前突的临床疗效。方法选取2016年5月至2018年10月在辽宁中医药大学附属第三医院肛肠科就诊的符合纳入标准的142例重度直肠前突患者为研究对象,采用随机数字表法将入选患者随机分为观察组(n=71,采用经肛闭式修补术联合自拟助阳通便膏方口服治疗)和对照组(n=71,采用经肛闭式修补术联合口服麻仁软胶囊治疗)。观察记录两组便秘相关症状评分(排便间隔时间、粪便性状、排便费力程度、排便不尽感及直肠肛门阻塞感改善情况)、临床疗效、复发情况,以及治疗安全性与不良反应情况。结果治疗前,两组便秘相关症状评分对比,差异均无统计学意义(均P>0.05)。治疗后,两组便秘相关症状评分均低于治疗前(均P<0.01),且观察组排便间隔时间评分、粪便性状评分、排便费力程度评分及排便不尽感评分均低于对照组,差异有统计学意义(均P<0.05)。观察组总有效率高于对照组,复发率低于对照组,差异均有统计学意义(均P<0.05)。术后复查两组患者心电图、血尿大便常规以及肝肾功能等安全性指标,均未见明显异常。两组患者均未发生严重的不良反应事件。结论经肛闭式修补术联合自拟助阳通便膏方口服治疗重度直肠前突疗效确切,安全性好,复发率低。Objectives To investigate the effect of transanal repair combined with oral Zhuyang Tongbian paste in treating pa?tients with severe rectocele.Methods A total of 142 patients with severe rectocele fulling the inclusion criteria at the Depart?ment of Anorectal Surgery of The Third Affiliated Hospital of Liaoning University Traditional Chinese Medicine from May 2016 to October 2018 were recruited.Patients were randomly assigned to the treatment group(n=71,transanal repair combined with oral Zhuyang Tongbian paste of in-house formula)and the control group(n=71,transanal repair combined with oral Maren soft capsule).Intervals between defecation,stool characteristics,intensity of defecation effort,tenesmus,sensation of anorectal obstruc?tion,effectiveness,recurrence,safety and complications were recorded.Results Scores of constipation symptoms did not differ be?tween groups before treatment(P>0.05).After treatment,the scores of constipation symtoms were lower than before treatment in both groups(P<0.01).And the scores of intervals between defecation,stool characteristics,the intensity of defecation effort,and tenesmus were significantly lower in the treatment group than in the control group(P<0.05).The overall effectiveness was signifi?cantly higher,and the recurrence rate was significantly lower in the treatment group(P<0.05).Postoperative re-examination of electrocardiogram,complete blood count,urinalysis,stool analysis,liver and kidney function did not show significant abnormalities in either group.No severe adverse events occurred in either group.Conclusion Transanal repair combined with oral Zhuyang Tongbian paste is effective and safe in treating severe rectocele with a low recurrence rate.

关 键 词：直肠前突 经肛闭式修补术 助阳通便膏方 

分 类 号：R657.1[医药卫生—外科学]